Throughout 2011 we are including special content in honor of MRB's 25th year. This month we reached out to some long-time readers who have been on board since MRB's early years, including some who have read every single issue! Read on to find out what they had to say.
To take a proactive approach to the RAC process, you will need to assess your current level of financial risk. You can do this internally or with the help of external resources. There are many good risk evaluation software tools on the market for hospitals and health systems; there are also consultants who specialize in reviewing hospitals' claims for proper coding and documentation to assess overall compliance risk and make suggestions for corrections. Once you identify and quantify your risk, you can begin to take action to mitigate the impact of a RAC audit of past claims and to improve your systems to avoid being out of compliance in the future.
Jean Stone, RHIT, CCS, has never met some of the coders who report directly to her. She has, however, spoken with them by phone, and in some cases, she has seen their wedding or other photographs. This is because nearly all members of her department work remotely.
The company, based in Prince George's County, MD, got hit in February with OCR's first civil money penalty for violations of the HIPAA Privacy Rule-a $4.3 million tab that included $3 million for failing to cooperate with the agency's investigation. OCR determined Cignet acted with "willful neglect" and did not take action to correct the violations, which allowed the agency to impose the highest level of fines based on its tiered penalty structure.
There are some Joint Commission EPs with which almost all hospital HIM departments struggle. Surveyors continue to focus on them, so chances are you should too.
